CMS Formulary

Displaying 135091-135100 of 1611142 results.
ID: 135091
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135092
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135093
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135094
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135095
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539248
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135096
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135097
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135098
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135099
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135100
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1